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Polyarteritis nodosa presenting as acute myocardial infarction in a young man: importance of invasive angiography
  1. Eric T McWilliams,
  2. Wadea Khonizy,
  3. Ahmad Jameel
  1. Departments of Cardiology and Internal Medicine, Dhahran Health Center, Dhahran, Saudi Arabia
  1. Correspondence to Dr Eric T McWilliams, Departments of Cardiology and Internal Medicine, Dhahran Health Center, Dhahran 31311, Saudi Arabia; eric.mcwilliams{at}gmail.com or eric.mcwilliams{at}aramco.com

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A 31-year-old man, with a low risk-factor profile for coronary disease, presented with atypical left-sided chest pain. ECGs were normal, however, cardiac Troponin I was elevated at 4.57 (ref <0.04). Invasive coronary angiography demonstrated an abnormality in the mid-left anterior descending artery (yellow arrow, figure 1: right hand panel zoomed image) suggestive of microaneurysm formation. left ventricular (LV) angiography revealed an area of hypokinesis.

Figure 1

Coronary …

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